TY - JOUR
T1 - Going to scale with professional skilled care
AU - Koblinsky, Marge
AU - Matthews, Zoë
AU - Hussein, Julia
AU - Mavalankar, Dileep
AU - Mridha, Malay K.
AU - Anwar, Iqbal
AU - Achadi, Endang
AU - Adjei, Sam
AU - Padmanabhan, P.
AU - van Lerberghe, Wim
N1 - Funding Information:
We thank Ardi Kaptiningsih of the WHO South East Asia Regional Office and Vincent Fauveau of the UN Population Fund for their rigorous and insightful review of this paper; all the participants at the maternal survival series review meeting in Geneva for helpful comments; and Diana Beck, Sandy Tebben Buffington, Lynn Sibley for their substantial contribution to the paper either through reviews or information. Additional work for the series was supported directly by the UK Department for International Development through a grant to the London School of Hygiene and Tropical Medicine, by the US Agency for International Development, and by the Initiative for Maternal Mortality Programme Assessment (funded by the Bill and Melinda Gates Foundation, the Department for International Development, the European Commission and the US Agency for International Development. The funding sources did not influence the content of this article, and have no responsibility for the information provided or views expressed in this paper.
PY - 2006/10/14
Y1 - 2006/10/14
N2 - Because most women prefer professionally provided maternity care when they have access to it, and since the needed clinical interventions are well known, we discuss in their paper what is needed to move forward from apparent global stagnation in provision and use of maternal health care where maternal mortality is high. The main obstacles to the expansion of care are the dire scarcity of skilled providers and health-system infrastructure, substandard quality of care, and women's reluctance to use maternity care where there are high costs and poorly attuned services. To increase the supply of professional skilled birthing care, strategic decisions must be made in three areas: training, deployment, and retention of health workers. Based on results from simulations, teams of midwives and midwife assistants working in facilities could increase coverage of maternity care by up to 40% by 2015. Teams of providers are the efficient option, creating the possibility of scaling up as much as 10 times more quickly than would be the case with deployment of solo health workers in home deliveries with dedicated or multipurpose workers.
AB - Because most women prefer professionally provided maternity care when they have access to it, and since the needed clinical interventions are well known, we discuss in their paper what is needed to move forward from apparent global stagnation in provision and use of maternal health care where maternal mortality is high. The main obstacles to the expansion of care are the dire scarcity of skilled providers and health-system infrastructure, substandard quality of care, and women's reluctance to use maternity care where there are high costs and poorly attuned services. To increase the supply of professional skilled birthing care, strategic decisions must be made in three areas: training, deployment, and retention of health workers. Based on results from simulations, teams of midwives and midwife assistants working in facilities could increase coverage of maternity care by up to 40% by 2015. Teams of providers are the efficient option, creating the possibility of scaling up as much as 10 times more quickly than would be the case with deployment of solo health workers in home deliveries with dedicated or multipurpose workers.
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U2 - 10.1016/S0140-6736(06)69382-3
DO - 10.1016/S0140-6736(06)69382-3
M3 - Review article
C2 - 17046470
AN - SCOPUS:33749676048
SN - 0140-6736
VL - 368
SP - 1377
EP - 1386
JO - The Lancet
JF - The Lancet
IS - 9544
ER -